Abstract
Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions (Mage 43 years, 88% identified as women) and collected measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression.
Highlights
Chronic pain conditions are prevalent and burdensome across the globe
The purpose of this study was to investigate variables associated with depression among a cohort of chronic pain individuals and examine whether sleep quality can moderate the effect of pain severity on depression, and pain interference on depression, among a chronic pain population
Our findings suggest that pain severity, pain interference, and sleep quality are all significantly associated with depression among this population
Summary
Chronic pain conditions are prevalent and burdensome across the globe. Depression is commonly reported among individuals with non-malignant chronic pain conditions which leads to impaired functioning and poor quality of life (IsHak et al, 2018). Estimates for depression among people with chronic pain have been reported between 20% and 60%, and evidence shows these individuals report a higher prevalence of depressive symptoms compared to a general population (Fishbain et al, 1997; Breivik et al, 2006; Rayner et al, 2016). The relationship between chronic pain and depression may be bidirectional and lead to poorer health-related quality of life, and in some cases, longer duration of physical and psychological symptoms (IsHak et al, 2018). Evidence has suggested that individuals with chronic pain and comorbid depression experience higher rates of physical, mental, and social dysfunction, and poorer response to pain treatments than chronic pain
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